Blue Rubber Bleb Nevus Syndrome

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Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare disorder characterized by the presence of multiple hemangiomas, or abnormal blood vessels, in the skin and gastrointestinal tract. This condition can lead to gastrointestinal bleeding, iron-deficiency anemia, and a range of symptoms including abdominal pain, melena, hematemesis, rectal bleeding, fatigue, weakness, and dyspnea. Understanding the causes, symptoms, and treatment options for BRBNS is crucial for individuals affected by this condition and their healthcare providers.

Hemangiomas: The Hallmark of BRBNS

Hemangiomas are the primary feature of BRBNS. These abnormal blood vessels can appear as blue or purple rubbery bumps on the skin, hence the name “blue rubber bleb nevus.” They can also develop internally in the gastrointestinal tract, particularly in the small intestine and colon. The presence of these hemangiomas in the gastrointestinal tract is what distinguishes BRBNS from other vascular malformation syndromes.

Gastrointestinal Bleeding and Iron-Deficiency Anemia

One of the most significant complications of BRBNS is gastrointestinal bleeding. The hemangiomas in the gastrointestinal tract can rupture or bleed, leading to blood loss. This chronic bleeding can result in iron-deficiency anemia, a condition characterized by low levels of iron in the body. Iron is essential for the production of red blood cells, and its deficiency can cause fatigue, weakness, and shortness of breath.

Recognizing the Symptoms

Individuals with BRBNS may experience a range of symptoms related to gastrointestinal bleeding and anemia. Abdominal pain is a common complaint, often described as cramping or aching. Melena, which refers to black, tarry stools, may indicate bleeding in the upper gastrointestinal tract. Hematemesis, or vomiting blood, can occur if the bleeding is severe. Rectal bleeding, characterized by bright red blood in the stool, may also be present.

Aside from gastrointestinal symptoms, individuals with BRBNS may experience fatigue, weakness, and dyspnea due to iron-deficiency anemia. These symptoms can significantly impact daily functioning and quality of life.

Diagnosis and Treatment

Diagnosing BRBNS can be challenging due to its rarity and the variability of symptoms. However, a thorough medical history, physical examination, and imaging studies can aid in the diagnosis. Endoscopy and colonoscopy may be performed to visualize the hemangiomas in the gastrointestinal tract.

While there is no cure for BRBNS, treatment focuses on managing symptoms and preventing complications. Iron supplementation is crucial to address iron-deficiency anemia. In severe cases of gastrointestinal bleeding, surgical intervention may be necessary to remove or control bleeding from the hemangiomas.

Living with BRBNS: Tips for Management

Living with BRBNS can be challenging, but there are strategies individuals can employ to manage their condition effectively:

  • Regular follow-up with a healthcare provider: It is essential to have regular check-ups to monitor the progression of the disease and manage symptoms.
  • Dietary modifications: Consuming iron-rich foods such as lean meats, leafy greens, and fortified cereals can help address iron-deficiency anemia.
  • Iron supplementation: Taking prescribed iron supplements as directed by a healthcare provider can help replenish iron stores in the body.
  • Managing stress: Stress can exacerbate symptoms, so finding healthy coping mechanisms such as exercise, meditation, or therapy can be beneficial.
  • Support networks: Connecting with others who have BRBNS or joining support groups can provide emotional support and valuable insights into managing the condition.


Blue Rubber Bleb Nevus Syndrome is a rare disorder characterized by the presence of hemangiomas in the skin and gastrointestinal tract. Gastrointestinal bleeding and iron-deficiency anemia are common complications, leading to symptoms such as abdominal pain, melena, hematemesis, rectal bleeding, fatigue, weakness, and dyspnea. While there is no cure for BRBNS, proper management and treatment can help individuals lead fulfilling lives. Regular medical follow-up, dietary modifications, iron supplementation, stress management, and support networks are essential components of managing this condition. By understanding the causes, symptoms, and available treatment options, individuals with BRBNS can take proactive steps towards improving their quality of life.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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